Brain tumours Flashcards
What are the primary brain tumours that arise in adults?
Glioblastoma multiforme Oligodendroglioma Meningioma Hemangioblastoma Pituitary adenoma Schwannoma
What is a gliobastoma multiforme?
Grade IV astrocytoma; a common and very malignant brain tumour with survival of about 1 year.
Which is the most common adult primary brain tumour?
gliobastoma multiforme
Where is a gliobastoma multiforme found?
In cerebral hemispheres and may cross corpus callosum
What does a gliobastoma multiforme stain positive for?
+ GFAP (astrocyte origin)
gliobastoma multiforme histology
pseudopalisading pleomorphic tumor cells border central area of necrosis, hemmorhage or microvascular proliferation
What is an oligodendroglioma?
A rare slow growing tumour usually inthe frontal lobes
oligodendroglioma histology
Fried egg appearnce of cells with chicken wire capillary pattern
Which is the second most common primary brain tumour of adults?
meningioma
Description of meningioma ?
Common and usually benign. Occurs near surface of brain in parasaggital region. Extra-axial and may have a dural attachment.
Where do you most commonly find a meningioma?
surface of brain in parasaggital region
presentation of meningioma
often asymptomatic but may present with seizures or focal neurological signs
treatment of meningioma
resection or radiosurgery
Which cell does a meningioma originate from?
arachnoid
Meningioma histology
spindle cells concentrically arranged in whorled pattern. Psammoma bodies.
Risk factor for meningioma
prior radiation to head
Where do hemangioblastomas usually occur?
in the cerebellum
which syndrome are hemangioblastomas associaed with
VHL syndrome
what may a hemangioblastomas produce?
erythropoeitin –» secondary polycythemia
hemangioblastoma histology
blood vessel origin - closely arranged thin walled-capillaries with minimal intervening parynchema
Pituitary adenoma presentation
Bitemporal hemianopia and potentially symptoms from hormones if producing them (most commonly prolactin)
Pituitary adenoma of lactotrophs presentation
overproduction of prolactin ->ammenhoria/galactorea, impotence and decreased libido in men, decreased bone density due to decreased estrogen in women
Pituitary adenoma of somatotrophs presentation
acromegaly and gigantism
Pituitary adenoma of corticotrophs presentation
ACTH excess -> cushing disease
Pituitary adenoma of thyrotrophs presentation
hyperthyroidism
treatment of pituitary adenoma
Dopamine agonists (bromocriptine, cabergoline), transphenoidal resection
Schwannomas are usually found where?
cerebellopontinge angle - involving both VII and VIII
How does a vestibular schwannomas present (one that effects CNVIII)
tinnitus and hearing loss
What disease are schwannomas associated wtih?
NFII
What do schwannomas stain positively for?
S100+ (schwan cell origin)
Schwannoma histology?
biphasic, dense, hypercellular areas with spindle cells alternating with hypocellular and myxoid areas
What are the childhood primary brain tumours?
Pilocytic astrocytoma Medulloblastoma Ependymoma Craniopharyngioma Pinealoma
What is a pilocytic astrocytoma?
low-grade astrocytome, the most common brain tumour in kids. Well-circumscribed with good prognosis. Benign.
Most common location for a pilocytic astrocytoma?
posterior fossa (cerebellum)
histology of pilocytic astrocytoma
GFAP + (astrocyte origin), rosenthal fibers - eosinophilic corkscrew fibers .
Cystic and solid
what does pilocytic astrocytoma stain + for?
GFAP
What is medulloblastoma?
most common malignant brain tumour of childhood. Commonly involve cerebellum.
Presentation of medulloblastoma?
Can compress the 4th ventricle -> noncommunicating hydrocephalus
->headaches and papilledema.
where may a medulloblastoma metastasize to?
spinal cord (drop metastasis)
a medulloblastoma is a form of what?
primitive neuroectodermal tumour
histology of medulloblastoma
homer-wright rosettes - small blue cells
Where is an ependymoma found?
4th ventricle
complication of ependymoma?
hydrocephalus
ependymoma histology
perivascular pseudorosettes and rod-shaped blepharoplasts (basal ciliary bodies) found near the nucleus
What is a craniopharyngioma?
Most common childhood supratentorial tumour
What may a craniopharyngioma be confused with?
pituitary adenoma (both cause bitemporal hemianopia)
What is a craniopharyngioma derived from?
remnants of Rathke pouch (ectoderm)
histology of craniopharyngioma
calcification may be seen
Cholesterol crystals found in motor oil like fluid within tumour
what is a pinealoma?
tumour of the pineal gland that may cause parinaud syndrome
which syndrome may a pinealoma cuase?
parinaud (compression of tectum -> gaze palsy)
presentation of pinealoma
patient cant look up, pseudo argyll robertson pupils, obstructive hydrocephalus and precocious puberty in males (may production hcG)
